摘要
目的比较腹腔镜胰十二指肠切除术(LPD)与开腹胰十二指肠切除术(OPD)的临床疗效。方法回顾性分析郑州大学人民医院2017年6月至2019年12月成功实施胰十二指肠切除术的386例患者临床资料,根据手术方式的不同,将患者分为LPD组(n=122)和OPD组(n=264),比较两组患者手术时间、术中出血量、术后住院时间、术后并发症、术后肿瘤学结果及预后情况的差异。结果共纳入386例患者,男性232例,女性154例,年龄(57.8±11.0)岁。LPD组患者手术时间(330.69±80.55)min长于OPD组患者(241.13±77.24)min,术中出血量300.00(200.00,400.00)ml少于OPD组400.00(262.50,500.00)ml,术后住院时间(12.21±5.24)d少于OPD组(16.61±6.63)d,两组比较差异均具有统计学意义(均P<0.05)。LPD组中36例(29.51%)患者出现术后并发症,OPD组中81例(30.68%)患者出现术后并发症,两组比较差异无统计学意义(P>0.05)。术后肿瘤学结果表明LPD组清扫淋巴结(12.65±5.03)个多于OPD组(10.07±5.09)个,差异具有统计学意义(P<0.05),但是两组患者在肿瘤的病理类型、大小、分化程度及R0切除率方面差异无统计学意义(均P>0.05)。两组患者均获得随访,中位随访时间20(6~36)个月,LPD组随访时间大于1年的恶性肿瘤患者存活率为84.72%(61/72),OPD组为85.81%(133/155),两组比较差异无统计学意义(P>0.05)。结论LPD是一种安全可行的手术方式并具有微创优势,临床疗效良好。
Objective This study aimed to compare the clinical outcomes of laparoscopic pancreaticoduodenectomy(LPD)versus open pancreaticoduodenectomy(OPD).Methods The clinical data of 386 patients who successfully underwent pancreaticoduodenectomy at the People's Hospital of Zhengzhou University from June 2017 to December 2019 were retrospectively analyzed.According to the different surgical methods,patients were divided into the LPD group(n=122)and the OPD group(n=264).The differences in operation time,intraoperative blood loss,postoperative hospital stay,postoperative complications,postoperative oncology survival outcomes and prognosis between groups were compared.Results Of 386 patients in this study,there were 232 males and 154 females,aged(57.8±11.0)years.The operation time of the LPD group was(330.69±80.55)min which was significantly longer than that of the OPD group(241.13±77.24)min.The intraoperative blood loss 300.00(200.00,400.00)ml was also significantly less than the OPD group 400.00(262.50,500.00)ml,and the length of postoperative stay in the LPD group(12.21±5.24)d was significantly less than the OPD group(16.61±6.63)d,(all P<0.05).There were 36 patients(29.51%)in the LPD group and 81 patients(30.68%)in the OPD group who developed postoperative complications,with no significant difference between groups(P>0.05).Postoperative oncology outcomes showed that the number of lymph nodes dissected in the LPD group was significantly more than that in the OPD group[(12.65±5.03)vs(10.07±5.09)],(P<0.05).There were no significant differences between the two groups in tumor pathology type,size,degree of differentiation and R0 resection rates(all P>0.05).All patients were followed up for 6-36 months,with a median follow-up of 20 months.The survival rates of patients with malignant tumors after following-up for more than 1 year in the LPD group was 84.72%(61/72),that in the OPD group was 85.81%(133/155),with no significant difference between groups(P>0.05).Conclusion LPD was safe and feasible with its advantages of minimally invasiveness.
作者
王宁
杨久辉
潘玉进
田广金
陶连元
穆森茂
余海波
李德宇
Wang Ning;Yang Jiuhui;Pan Yujin;Tian Guangjin;Tao Lianyuan;Mu Senmao;Yu Haibo;Li Deyu(Department of Hepatobiliary Surgery,People’s Hospital of Zhengzhou University(Henan Provincial People’s Hospital),Zhengzhou 450003,China)
出处
《中华肝胆外科杂志》
CAS
CSCD
北大核心
2021年第8期594-598,共5页
Chinese Journal of Hepatobiliary Surgery
基金
河南省医学科技攻关项目(201602258,212102310132)。
